Provider Demographics
NPI:1225284276
Name:MCBRIDE, MICHAEL TRENT (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TRENT
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9250 N 3RD STREET
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2432
Mailing Address - Country:US
Mailing Address - Phone:602-633-3800
Mailing Address - Fax:602-861-3500
Practice Address - Street 1:9250 N. 3RD STREET
Practice Address - Street 2:SUITE 4000
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2432
Practice Address - Country:US
Practice Address - Phone:602-633-3800
Practice Address - Fax:602-861-3500
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44508207ZP0102X
KY42303207ZP0102X, 207ZC0500X, 207ZH0000X
KYR1279207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ688237Medicaid
AZZ153167Medicare PIN